小剂量泼尼松联合他克莫司治疗小儿过敏性紫癜性肾炎临床观察  

Clinical Observation of Small Dose Prednisone Combined with Tacrolimus in the Treatment of Children with Anaphylactoid Purpura Nephritis

作　　者：喻娟 张玉梅 赵丽军 Yu Juan;Zhang Yumei;Zhao Lijun(Shenzhen Longhua District Central Hospital,Guangdong Shenzhen 518110,China)

机构地区：[1]深圳市龙华区中心医院

出　　处：《中国药师》2019年第11期2055-2058,共4页China Pharmacist

摘　　要：目的:观察小剂量泼尼松联合他克莫司治疗小儿过敏性紫癜性肾炎的疗效及对血清基质金属蛋白酶2(MMP2)、基质金属蛋白酶9(MMP9)、基质金属蛋白酶组织抑制因子1(TIMP1)水平的影响。方法:102例过敏性紫癜性肾炎患儿随机分为两组各51例,在基础治疗同时,对照组予小剂量醋酸泼尼松片联合环磷酰胺治疗,观察组予小剂量醋酸泼尼松片联合他克莫司治疗。持续治疗3个月后,比较两组治疗后临床疗效与药品不良反应、治疗前后肾功能和血清MMP2、MMP9、TIMP1水平变化。结果:治疗后,观察组和对照组治疗总有效率分别为94.12%和70.59%,差异有统计学意义(P<0.05)。两组24 h尿蛋白定量(24hUpro)、尿β2-微球蛋白(β2-MG)、尿微量白蛋白(mALB)、血肌酐(SCr)、血尿素氮(BUN)以及血清MMP2、MMP9、TIMP1水平均较治疗前降低(P<0.05),且观察组上述指标明显低于对照组(P<0.05)。两组药品不良反应发生率比较,差异无统计学意义(P>0.05)。结论:小剂量泼尼松联合他克莫司治疗小儿过敏性紫癜性肾炎,疗效显著,同时能明显降低血清MMP2、MMP9、TIMP1水平。Objective:To observe the effect of small dose prednisone combined with tacrolimus in the treatment of children with anaphylactoid purpura nephritis and its influence on serum levels of matrix metalloproteinase 2(MMP2),matrix metalloproteinase 9(MMP9)and tissue inhibitor of matrix metalloproteinase 1(TIMP1).Methods:Totally 102 children with anaphylactoid purpura nephritis were randomly divided into two groups.The 51 cases in the control group were treated with low dose prednisone combined with cyclophosphamide,and another 51 cases in the observation group were treated with small dose prednisone combined with tacrolimus.Both groups were treated for 3 months.The clinical efficacy after the treatment was compared between the groups.The levels of renal function and serum MMP2,MMP9 and TIMP1 were detected before and after the treatment in the two groups.The occurrence of adverse reactions during the treatment in the two groups was also recorded.R esults:After the treatment,the total effective rate of the observation group and the control group was 94.12%and 70.59%,respectively(P<0.05).After the treatment,24 h urinary protein quantitation(24hUpro),urine beta 2-microglobulin(β2-MG),microalbuminuria(mALB),serum creatinine(Scr),blood urea nitrogen(BUN)and serum MMP2,MMP9 and TIMP1 levels were significantly lower than those before the treatment in both groups,and the differences were statistically significant(P<0.05),and the decrease in the observation group was more significant than that in the control group(P<0.05).During the period of treatment,there was no significant difference in the incidence of adverse reactions between the groups(P>0.05).Conclusion:Small dose prednisone combined with tacrolimus in the treatment of children with anaphylactoid purpura nephritis shows significant effect,and can obviously reduce the serum levels of MMP2,MMP9 and TIMP1.

关 键 词：泼尼松 他克莫司 过敏性紫癜性肾炎 基质金属蛋白酶2 基质金属蛋白酶9 基质金属蛋白酶组织抑制因子1 

分 类 号：R979.5[医药卫生—药品]